In general, Mindfulness Based Interventions have the strongest effects on self-reported sleep quality and on decreasing total wake time in people with insomnia. Additionally, it has been shown to positively affect the severity of insomnia as well. These benefits are achieved because through the the targeting of arousal in mindfulness practices, a mindful stance can be achieved, thus decreasing sleep arousal and allowing for normal sleep patterns to emerge. 

Mindfulness and Effects on Insomnia

Cognitive Behavior Therapy for Insomnia is the most widely used and recommended psychological treatment for chronic insomnia. CBT-I uses interventions involving sleep hygiene, stimulus control, sleep restriction, and cognitive therapy. CBT-I is moderately effective, but may not address hyper-arousal, which is known as a perpetuating factor for insomnia. If CBT-I is not effective in reducing hyper-arousal, then Mindfulness-Based Therapy should be used as treatment for chronic insomnia. MBTI uses the development of a metacognitive process and meditation practice to reduce cognitive and physiological hyper-arousal.Through the improvement of maladaptive thinking instead of challenging content directly, MBTI is ideal to improve sleep for those who do not respond to CBT-I.

Insomnia: The Difference in Treatment between Cognitive Behavior Therapy (CBT-I) and Mindfulness-Based Therapy for Chronic Insomnia (MBTI)

People with narcolepsy can differ substantially in how their symptoms appear and in how well available treatments work. McCarty's case study illustrates this variability: a 50-year-old woman had excessive sleepiness during waking hours, unusual right-sided cataplexy, no dream-like hallucinations, little improvement with a stimulant alone, and major improvement when the stimulant was paired with an antidepressant.

Variability in Narcolepsy Symptoms and Treatment Response

This list includes different types of methods for treating and/or managing different sleep-wake disorders. These include:
-	Narcolepsy Treatment 
-	Mindfulness and Effects on Insomnia
-	Insomnia Treatment Differences Between CBT-I & MBTI

Sleep-Wake Disorders are defined using a multidimensional approach due to the expectations for co-existing or comorbid diagnosis in both mental and neurological health. They are largely characterized by individual’s interpretation of having dissatisfying sleep quality, timing, or amount of sleep. These complaints are often expressed alongside issues of distress or impairment during expected daytime activities. 

Sleep-Wake Disorders

The DSM-5-TR separates Sleep-Wake Disorders into the following specific disorders and groups:
-	Insomnia Disorder
-	Hypersomnolence Disorder
-	Narcolepsy
-	Breathing Related Sleep-Disorders*
-	Circadian Rhythm Sleep-Wake Disorders*
-	Parasomnias*
-	Restless Leg Syndrome
-	Substance / Medication-Induced Sleep Disorder
-	Other Specified Insomnia Disorder
-	Unspecified Insomnia Disorder
-	Other Specified Hypersomnolence Disorder
-	Unspecified Hypersomnolence Disorder
-	Other Specified Sleep-Wake Disorder
-	Unspecified Sleep-Wake Disorder

Note: * Groups that separate into further specific disorders

[DSM-5-TR] List of Sleep-Wake Disorders

The DSM-5-TR takes a section to briefly define important terminology related to sleep-wake disorders. These terms are broadly separated into two categories based on the type or stage of sleep, and the use of polysomnography and measurement of sleep. 
-	Sleep Stages Terms
-	Polysomnography and Measurement Terms


[DSM-5-TR] Key Concepts and Terms for Sleep-Wake Disorders

The DSM-5-TR makes a note to mention the common occurrence of co-occurring disorders that are diagnosed alongside a sleep-wake disorder. These co-occurring conditions frequently involve depression, anxiety, and cognitive changes. It is also recognized that sleep disturbances are recognized risk factors for developing other mental disorders (e.g., substance use disorder). Thus, when evaluating sleep disturbances as a differential diagnosis, the rule is to consider co-existence rather than differential diagnosis. Because of the importance of sleep on other mental or physical conditions, as well as the inverse effect of mental and physical conditions on sleep, it is important to plan treatment using a multidimensional approach that encompasses all the conditions of the patient. 

[DSM-5-TR] Note of Co-Occurring Disorders and Differential Diagnosis to Sleep-Wake Disorders

The DSM-5-TR makes an important note to specify the connection that sleep-wakes disorders, such as insomnia, have to suicidal thoughts, behavior, and death. Multiple studies, even when adjusting for depression, have correlated sleep-wake disorders and nightmares, increasing the risk of suicidal thoughts and behaviors. Some data collected on college students showed that 31.3% of those with sleep problems had suicidal thoughts, and inversely, 82.7% of those with suicidal thoughts, had sleep problems. Additionally, the American Academy of Sleep Medicine has also concluded that for teenagers, less than 8 hours of sleep is associated with increased risk for self-harm and suicidal thoughts and/or behaviors. 

[DSM-5-TR] Note of Sleep-Wake Disorders Association With Suicidal Thoughts or Behaviors

This list includes disorders or conditions that are related to states or features of sleeping, waking, or the processes that occur in between, but are not currently directly or officially included in the DSM. These disorders include:
-	Sleep Enuresis (Bedwetting)
-	Sleep Paralysis
-	Sleep-State Misperception
-	Sudden Infant Death Syndrome (SIDS)


List of Other Recognized Sleep-Wake Disorders

Treatment & Management Methods for Sleep-Wake Disorders

This list includes different theories or concepts that are used to explain, define, or otherwise provide further insight into the workings of sleep-wake disorders. These include:
- Current Scales to Measure Sleep-Wake Disorder Symptoms


Theories & Concepts Relevant to Sleep-Wake Disorders

This includes the intersection of connections and/or research related to sleep-wake disorders as a general category in other fields of study and research. Such fields include:
-	TBD

Note: Add subjects as needed

Interdisciplinary Connections & Research Related to Sleep-Wake Disorders

The collection of references pertaining to sleep-wake disorders.

References for Sleep-Wake Disorders

Key learning objectives for understanding common sleep disorders include the ability to describe the symptoms and treatments for insomnia, sleep apnea, and narcolepsy. Additionally, one should be able to recognize the symptoms of various parasomnias and identify the risk factors and preventive measures associated with sudden infant death syndrome (SIDS).

Learning Objectives for Common Sleep Disorders

Studies indicate that a significant portion of the population, ranging from 30% to 50%, will experience a sleep disorder at some point during their lifetime. The exact percentage can vary depending on the specific population and disorder being examined (Bixler, Kales, Soldatos, Kaels, & Healey, 1979; Hossain & Shapiro, 2002; Ohayon, 1997, 2002; Ohayon & Roth, 2002).

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